Pertussis - Whooping Cough

Pertussis is a highly contagious bacterial disease that causes uncontrollable, violent coughing. The coughing can make it hard to breathe. A deep "whooping" sound is often heard when the patient tries to take a breath.

Causes, incidence, and risk factors

Pertussis, or whooping cough, is an upper respiratory infection caused by the Bordetella pertussis or Bordetella parapertussis bacteria. It is a serious disease that can cause permanent disability in infants, and even death.

When an infected person sneezes or coughs, tiny droplets containing the bacteria move through the air, and the disease is easily spread from person to person. The infection usually lasts 6 weeks.

Whooping cough can affect people of any age. Before vaccines were widely available, the disease was most common in infants and young children. Now that most children are immunized before entering school, the higher percentage of cases is seen among adolescents and adults.

Symptoms

Initial symptoms, similar to the common cold, usually develop about a week after exposure to the bacteria.

Severe episodes of coughing start about 10 to 12 days later. In children, the coughing often ends with a "whoop" noise. The sound is produced when the patient tries to take a breath. The whoop noise is rare in patients under 6 months of age and in adults.

Coughing spells may lead to vomiting or a short loss of consciousness. Pertussis should always be considered when vomiting occurs with coughing. In infants, choking spells are common.

Other pertussis symptoms include:

Runny nose

Slight fever (102 °F or lower)

Diarrhea

Signs and tests

The initial diagnosis is usually based on the symptoms. However, when the symptoms are not obvious, pertussis may be difficult to diagnose. In very young infants, the symptoms may be caused by pneumonia instead.

To know for sure, the health care provider may take a sample of mucus from the nasal secretions and send it to a lab, which tests it for pertussis. While this can offer an accurate diagnosis, the test takes some time, and treatment is usually started before the results are ready.

Some patients may have a complete blood count that shows large numbers of lymphocytes.

Treatment

If started early enough, antibiotics such as erythromycin can make the symptoms go away more quickly. Unfortunately, most patients are diagnosed too late, when antibiotics aren't very effective. However, the medicines can help reduce the patient's ability to spread the disease to others.

Infants younger than 18 months need constant supervision because their breathing may temporarily stop during coughing spells. Infants with severe cases should be hospitalized.

Chickenpox

Caused by the varicella-zoster virus (VZV), chickenpox used to be a common illness among kids in the United States (particularly among those under age 12). An itchy rash of spots that look like blisters can appear all over the body and be accompanied by flu-like symptoms. Chickenpox is very contagious, so an infected child should stay home and rest until the rash is gone.

Kids can be protected from VZV by getting the chickenpox (varicella) vaccine. The vaccine significantly reduces the chances of getting chickenpox. Vaccinated kids who do get chickenpox tend to have milder cases and quicker recoveries compared to those who contract the virus and aren't immunized.

How Did "Chickenpox" Get It's Name?

No one knows for sure. Some people think it's because the blisters caused by chickenpox look like chickpeas (garbanzo beans). Others think it's because the blisters resemble the peck marks of a chicken. But regardless of how it got its name, you can't catch chickenpox from a chicken!

Symptoms

A hallmark of chickenpox is that all stages (red bumps, blisters, and scabs) can appear on the body at the same time. The rash may be more extensive or severe in kids who have skin disorders like eczema, or weak immune systems. Young kids tend to have a mild illness with fewer blisters than older children or adults.